Two regimens for POST-exposure prophylaxis
Intradermal (ID) route: Updated Thai Red Cross regimen
Consists of:
0.1 ml intradermally
4 visits: 2 doses are given at each visit, hence: 8 doses
Days 0, 3, 7 & 28 (day 0 is the day of first dose)
Abbreviation: 2-2-2-0-2
Suturing, if required, should be delayed for a few hours to allow RIG to diffuse through the tissues before further trauma.
If suturing is necessary to control bleeding and in severe bites, first infiltrate the wound with RIG with as much amount as is possible anatomically and then loosely suture.
Facial wounds may need to be sutured early to avoid disfiguration. This may be done ONLY AFTER careful local infiltration with RIG
1.Immediately wash all the wounds with lots of water and soap. Ensure thorough flushing and that all the wounds are washed.
• Washing with soap and water should be started as soon as possible and continued for 15 minutes.
• Such thorough washing will remove a major amount of virus from the wound.
It is of utmost importance that all the wounds are detected and each one managed.
Rabies may manifest in one of the two forms:
1. Encephalitic (Furious) rabies
2. Paralytic (Dumb) rabies
Furious or encephalitic rabies
Hydrophobia (fear of water)
Photophobia (fear of light)
Aerophobia (fear of breeze)
Q. What should one do immediately after a dog bite?
1. Immediately wash all the wounds with lots of water and soap. Ensure thorough flushing and that all the wounds are washed.
• Washing with soap and water should be started as soon as possible and continued for 15 minutes.
• Such thorough washing will remove a major amount of virus from the wound.
2. Application of antiseptics: Povidone Iodine or any antiseptic with virucidal activity.
Limit or totally avoid consumption of foods made using industrial trans-fats.
The cooking fat should be rich in polyunsaturated and monounsaturated fatty acids e.g. Vegetable oils. Some vegetable oil examples are soybean oil, corn oil, rice bran oil, canola oil, sunflower oil, safflower oil, olive oil etc.
Food industry and restaurants should use healthier alternatives to industrial trans-fats.
Any food items prepared in oils which are partially hydrogenated vegetable oils contain trans-fats.
Examples of partially hydrogenated oils in India:
• Vanaspati ghee
• Margarine
• Bakery shortening/ bakery ghee
• Vegetable shortening
• Certain microwavable popcorn
• Some margarines
• Fried fast food
• Bakery items prepared using vegetable shortening, bakery shortening or margarine e.g. cakes, pastries, muffins doughnuts
• Non-Dairy Creamers
Non-dairy creamers are intended to replace milk in hot beverages.
In past, these were prepared from partially hydrogenated oil, but some companies have replaced TFA with healthier oils
• Potato chips
• Corn chips
• Some sweet pies contain trans-fat in the crust. Read the label
The major source of dietary TFA is Industrial i.e. partial hydrogenation of vegetable/fish oils
1. Small amounts of trans-fatty acids do occur naturally in animal fat e.g.
Meat of ruminant animals (like cattle, sheep, goats)
Milk of ruminants and dairy products from such milk
These account for a very small percent (2-5%) of animal fat.
Some researchers claim animal origin TFA to be even beneficial.
Moderate intake of animal fat doesn’t seem to be harmful.
Cis and Trans configurations are terms used in organic chemistry to depict the 3-D arrangement of carbon atoms across a double bond. Trans-fatty acids (TFAs) are unsaturated fatty acids containing at least one double bond in the trans configuration.
Cis and trans isomers often have different physical properties. Generally, trans isomers are more stable than cis isomers
In nature, most unsaturated fatty acids occur as cis – configuration and NOT as trans – configuration.
